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Nevin Manimala Statistics

Can Twitter posts serve as early indicators for potential safety signals? A retrospective analysis

Int J Risk Saf Med. 2022 Apr 26. doi: 10.3233/JRS-210024. Online ahead of print.

ABSTRACT

BACKGROUND: As Twitter has gained significant popularity, tweets can serve as large pool of readily available data to estimate the adverse events (AEs) of medications.

OBJECTIVE: This study evaluated whether tweets were an early indicator for potential safety warnings. Additionally, the trend of AEs posted on Twitter was compared with AEs from the Yellow Card system in the United Kingdom.

METHODS: English Tweets for 35 drug-event pairs for the period 2017-2019, two years prior to the date of EMA Pharmacovigilance Risk Assessment Committee (PRAC) meeting, were collected. Both signal and non-signal AEs were manually identified and encoded using the MedDRA dictionary. AEs from Yellow Card were also gathered for the same period. Descriptive and inferential statistical analysis was conducted using Fisher’s exact test to assess the distribution and proportion of AEs from the two data sources.

RESULTS: Of the total 61,661 English tweets, 1,411 had negative or neutral sentiment and mention of at least one AE. Tweets for 15 out of the 35 drugs (42.9%) contained AEs associated with the signals. On pooling data from Twitter and Yellow Card, 24 out of 35 drug-event pairs (68.6%) were identified prior to the respective PRAC meetings. Both data sources showed similar distribution of AEs based on seriousness, however, the distribution based on labelling was divergent.

CONCLUSION: Twitter cannot be used in isolation for signal detection in current pharmacovigilance (PV) systems. However, it can be used in combination with traditional PV systems for early signal detection, as it can provide a holistic drug safety profile.

PMID:35491804 | DOI:10.3233/JRS-210024

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Nevin Manimala Statistics

Frequency of Depressive Disorders in Parkinson’s Disease: A Systematic Review and Meta-Analysis

J Parkinsons Dis. 2022 Apr 27. doi: 10.3233/JPD-223207. Online ahead of print.

ABSTRACT

BACKGROUND: Depressive disorders are recognized as a common neuropsychiatric disorder of Parkinson’s disease (PD). Reported frequencies vary widely among studies and depend on the diagnostic criteria, the methods of ascertainment used, and the population sampled.

OBJECTIVE: We aimed to evaluate the frequency of depressive disorders in PD and to investigate the relationship with PD clinical variables.

METHODS: A systematic review and meta-analysis of observational studies (community-based, prospective and retrospective cohort, case-control, community-based, and cross-sectional studies) reporting the frequency of depressive disorders in PD patients.

RESULTS: Electronic database search wielded 3,536 articles; an additional 91 were identified through citation chaining. 163 full-text articles were assessed for eligibility. Of these, 49 met the inclusion criteria for our analysis. The pooled frequency of depressive disorders was 30.7% (95% confidence interval [CI] 25.6 to 36.2; I2 = 95% ; 49 studies; combined n = 10,039). The pooled frequency of major depressive disorder was 14.0% (95% CI 10.5 to 18.5; I2 = 88% ; 23 studies; combined n = 5,218). Subgroup/meta-regression analyses were conducted to investigate the relationship between frequency and study inclusion criteria, methodology used for diagnosis, and study design. We found a statistically significant correlation between study design and depressive disorders frequency (ranging from 8% in the community-based study to 44% in the retrospective studies) and a statistically significant positive correlation between mean baseline PD duration and major depressive disorder frequency.

CONCLUSION: The current meta-analysis found a global frequency of depressive disorders of 30.7% and major depressive disorder of 14.0% . Study design influenced the frequency of depressive disorders in PD. Mean baseline PD duration and major depressive disorder frequency were positively correlated.

PMID:35491801 | DOI:10.3233/JPD-223207

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Nevin Manimala Statistics

A Stacking Framework for Multi-Classification of Alzheimer’s Disease Using Neuroimaging and Clinical Features

J Alzheimers Dis. 2022 Apr 27. doi: 10.3233/JAD-215654. Online ahead of print.

ABSTRACT

BACKGROUND: Alzheimer’s disease (AD) is a severe health problem. Challenges still remain in early diagnosis.

OBJECTIVE: The objective of this study was to build a Stacking framework for multi-classification of AD by a combination of neuroimaging and clinical features to improve the performance.

METHODS: The data we used were from the Alzheimer’s Disease Neuroimaging Initiative database with a total of 493 subjects, including 125 normal control (NC), 121 early mild cognitive impairment, 109 late mild cognitive impairment (LMCI), and 138 AD. We selected structural magnetic resonance imaging (sMRI) features by voting strategy. The imaging features, demographic information, Mini-Mental State Examination, and Alzheimer’s Disease Assessment Scale-Cognitive Subscale were combined together as classification features. We proposed a two-layer Stacking ensemble framework to classify four types of people. The first layer represented support vector machine, random forests, adaptive boosting, and gradient boosting decision tree; the second layer was a logistic regression classifier. Additionally, we analyzed performance of only sMRI feature and combined features and compared the proposed model with four base classifiers.

RESULTS: The Stacking model combined with sMRI and non-imaging features outshined four base classifiers with an average accuracy of 86.96% . Compared with using sMRI data alone, sMRI combined with non-imaging features significantly improved diagnostic accuracy, especially in NC versus LMCI and LMCI versus AD by 14.08% .

CONCLUSION: The Stacking framework we used can improve performance in diagnosis of AD using combined features.

PMID:35491782 | DOI:10.3233/JAD-215654

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Nevin Manimala Statistics

Importance of Task Selection for Connected Speech Analysis in Patients with Alzheimer’s Disease from an Ethnically Diverse Sample

J Alzheimers Dis. 2022 Apr 25. doi: 10.3233/JAD-220166. Online ahead of print.

ABSTRACT

Features of linguistic impairment in Alzheimer’s disease (AD) are primarily derived from English-speaking patients. Little is known regarding such deficits in linguistically diverse speakers with AD. We aimed to detail linguistic profiles (speech rate, dysfluencies, syntactic, lexical, morphological, semantics) from two connected speech tasks-Frog Story and picture description-in Bengali-speaking AD patients. The Frog Story detected group differences on all six linguistic levels, compared to only three with picture description. Critically, Frog Story captured the language-specific differences between the groups. Careful consideration should be given to the choice of connected speech tasks for dementia diagnosis in linguistically diverse populations.

PMID:35491794 | DOI:10.3233/JAD-220166

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Nevin Manimala Statistics

Strategies Associated with Retaining Participants in the Longitudinal National Alzheimer’s Coordinating Center Uniform Data Set Study

J Alzheimers Dis. 2022 Apr 25. doi: 10.3233/JAD-215537. Online ahead of print.

ABSTRACT

BACKGROUND: Best approaches for retaining research participants in Alzheimer’s disease cohort studies are understudied.

OBJECTIVE: Using data from the National Alzheimer’s Coordinating Center Uniform Data Set, we evaluated the associations of unique strategies with participant retention across Alzheimer’s Disease Research Centers and explored potential effect modification by race/ethnicity and diagnostic group.

METHODS: We examined retention at the first follow-up visit among participants enrolled during 2015-2017. Structured surveys ascertained 95 retention tactics among 12 strategies. Strategy-specific summary scores were created based on the number of implemented tactics for each strategy and grouped into tertiles. Generalized estimating equations were constructed to evaluate associations of strategy scores and the odds of retention, controlling for age, sex, education, race and ethnicity, study partner type, marital status, visit length, battery length, and diagnostic group. Separate models were stratified by race/ethnicity and diagnostic group. Effect modification was formally tested with interaction terms.

RESULTS: Among 5,715 total participants enrolled, 4,515 were Non-Hispanic White (79%), 335 were Hispanic/Latino (6%), 651 were Non-Hispanic Black (11%), and 214 were Non-Hispanic Asian (4%). Compared to the lowest tertile of scores, the highest tertile of scores involving improvement in study personnel and communication of study requirements and details were associated with 61% higher odds of retention in fully adjusted models (adjusted Odds Ratios [aOR] = 1.61, 95% Confidence Interval [CI] = 1.05-2.47 and aOR = 1.55, 95% CI = 1.03-2.35, respectively). We did not find evidence for effect modification.

CONCLUSION: In the setting of limited resources, specific retention strategies may be more valuable than others.

PMID:35491778 | DOI:10.3233/JAD-215537

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Nevin Manimala Statistics

Osteoporosis knowledge and health beliefs among middle-aged men and women in the Southern United States

J Osteopath Med. 2022 May 3. doi: 10.1515/jom-2022-0011. Online ahead of print.

ABSTRACT

CONTEXT: The most common skeletal disease, osteoporosis, causes bone fragility due to decreased bone mass and bone microarchitecture destruction. The health belief model is often applied to asymptomatic, prevention-related diseases such as osteoporosis. Steps to mitigate the insidious nature of osteoporosis, including education, motivation, and monitoring of bone mineral density, must begin at an earlier age.

OBJECTIVES: This study evaluates the knowledge and health beliefs surrounding osteoporosis in a population of males and females 35-50 years old to determine sex-based differences in osteoporosis knowledge and beliefs and to assess the correlation between perceptions and health motivation.

METHODS: Participants (81 males, 92 females) completed two questionnaires: the Osteoporosis Knowledge Test and the Osteoporosis Health Belief Scale. Descriptive statistics were performed along with Pearson product-moment correlation analysis to determine the relationships between the variables. Sex-based differences were calculated utilizing independent t-tests.

RESULTS: We discovered a statistically significant negative correlation between the barriers to exercise and health motivation (-0.434, p < 0.001) and a statistically significant positive correlation between the benefits of exercise and health motivation (0.385, p < 0.001). However, there was not a statistically significant correlation between health motivation with the following: the benefits of calcium, susceptibility, and the seriousness of osteoporosis. Between males and females, there was a statistically significant difference in exercise and calcium knowledge, susceptibility, and the benefits of both exercise and calcium (p < 0.05).

CONCLUSIONS: Males and females 35-50 years old perceive themselves to have a low susceptibility to osteoporosis. They do not consider osteoporosis a serious disease and have little motivation to mitigate its inception or progression. Their perceptions show that barriers to exercise impact health motivation more than the perceived benefits of exercise.

PMID:35491729 | DOI:10.1515/jom-2022-0011

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Nevin Manimala Statistics

Evaluation of the safety of 500 mg intravenous push thiamine at a tertiary academic medical center

Sci Prog. 2022 Apr-Jun;105(2):368504221096539. doi: 10.1177/00368504221096539.

ABSTRACT

Background: Thiamine, also known as vitamin B1, is an essential water-soluble micronutrient. Although thiamine has minimal safety concerns, parenteral administration has been associated with rare cases of anaphylactic shock, cardiac arrest, and injection site reaction. The objective of this analysis is to evaluate the incidence of anaphylaxis and injection site reactions associated with the administration of thiamine 500 mg as an intravenous (IV) push in adult patients. Method: This single-center, retrospective analysis was performed at Brigham and Women’s Hospital in Boston, Massachusetts. Electronic health records were used to identify all adult patients who were ordered for thiamine 500 mg IV push between July 1, 2020, and December 31, 2020. For the major and minor endpoints, anaphylaxis and injection site reactions were assessed, respectively. Descriptive statistics were used as appropriate. Results: A total of 463 doses of thiamine in 69 patients were evaluated. Thiamine was administered peripherally for 392 (84.7%) doses and centrally for 68 (14.7) doses. No anaphylactic reactions were observed. A total of 4 injection site reactions (0.86%) were noted with 4 unique doses. All reactions were classified as low-grade based on our institutional grading system. All injection site reactions were classified as “possible” (Naranjo score of 1-4). Conclusion: Administration of IV push 500 mg thiamine was not associated with anaphylactic events and was associated with a low rate of injection site reactions.

PMID:35491726 | DOI:10.1177/00368504221096539

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Nevin Manimala Statistics

Does the use of proton pump inhibitors in children affect ventricular repolarisation parameters?

Cardiol Young. 2022 May 2:1-5. doi: 10.1017/S104795112200138X. Online ahead of print.

ABSTRACT

Proton pump inhibitors are widely used agents in the treatment of dyspepsia, and their effects on ventricular repolarisation through ion channels are well-known. Our aim is to evaluate the change in ventricular repolarisation parameters on electrocardiogram before and after proton pump inhibitor treatment. This study included 69 patients who had symptoms such as burning stomach pain, bloating, nausea, and heartburn for at least 3 months. Electrolyte levels of the patients were measured before and after treatment, and 12-lead electrocardiograms were taken at the initial and 1st month follow-up visit. Heart rate, QT interval, corrected QT (QTc), QT dispersion (QTd), QTc dispersion (QTcd), Tp-e measurements, and Tp-e/QT ratio were calculated and compared. Thirty-nine of the patients were girls, 30 were boys, and the mean age was 13.16 ± 3.02 years. Electrolyte levels of the patients before and after treatment were within the normal range. There was no statistically significant difference in the QTc, the Tp-e duration, or the Tp-e/QT ratio of the patients before and after treatment. We did not find a significant prolongation in the QTc duration or any other ventricular repolarisation parameters after proton pump inhibitor treatment in children with dyspepsia. We did not observe ventricular arrhythmia in our patients during follow-up. However, different results might be obtained with a larger sample and a longer follow-up period. These patients may have an increased risk of developing ventricular arrhythmias. Therefore, precaution should be taken when using drugs that prolong the QT period, and follow-up with serial electrocardiograms should be planned.

PMID:35491713 | DOI:10.1017/S104795112200138X

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Nevin Manimala Statistics

Harm Reduction Policy Support among Students at Two U.S. Universities

Subst Use Misuse. 2022 May 2:1-9. doi: 10.1080/10826084.2022.2069265. Online ahead of print.

ABSTRACT

Background: The U.S. is undergoing an opioid overdose crisis. Harm reduction (HR) policies are associated with decreased overdose deaths and incidence of communicable diseases, yet legality of HR policies differs across U.S. jurisdictions. College student perceptions of HR policies are underexplored, even though their voting behavior has increased in recent years. We sought to compare their support of different HR policies and to explore relationships between demographic characteristics and support for HR policies. Methods: We collected cross-sectional, convenience sample survey data from undergraduate students at two large public universities, one in the Midwest and one in the Southeast, during Fall 2018/Spring 2019. We analyzed data using descriptive statistics and logistic regressions. Results: The final sample included 1,263 respondents. Good Samaritan laws (n = 833, 66%) and naloxone distribution (n = 476, 37.7%) were most commonly supported, while heroin maintenance treatment (n = 232, 18.4%) and heroin decriminalization (n = 208, 16.5%) were least supported. Democrat/liberal or less religious/spiritual respondents supported HR policies more than their Republican/conservative or religious/spiritual counterparts. Midwestern students were more likely to support syringe services programs. Conclusion: HR education initiatives could target religious and/or Republican/conservative students, as they have lower HR support. Among HR policies, Good Samaritan policies may be easiest to pass in college communities.

PMID:35491710 | DOI:10.1080/10826084.2022.2069265

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Nevin Manimala Statistics

Does Time of Administration of Intravenous Ketorolac Impact Pain-Related Outcomes in Dacryocystorhinostomy?

Orbit. 2022 Apr 30:1-5. doi: 10.1080/01676830.2022.2058021. Online ahead of print.

ABSTRACT

PURPOSE: An emerging body of evidence indicates that intravenous ketorolac (IVK) reduces pain scores and the requirement for opioid analgesics in a variety of oculofacial procedures. This study was performed to assess the impact of timing of IVK administration on these benefits after external dacryocystorhinostomy (DCR).

METHODS: Patients were randomized to receive IVK before (n = 50), during (n = 50), or after DCR (n = 50). An additional cohort of control patients did not receive the medication (n = 50). Postoperative pain was measured via a visual analog scale immediately after DCR on the first day after surgery (POD1). Additionally, the need for opioid analgesics to control pain was recorded. Statistical analyses were performed via a dedicated computerized software package.

RESULTS: Immediately after surgery, mean pain scores were 5.26 for control patients, and 2.30, 2.44, and 2.36 for patients that received IVK pre-, intra-, and post-operatively, respectively (p < .001 for each condition, as compared to controls). On POD1, mean pain scores were 3.52 for control patients and 1.38, 1.32, and 1.28 for patients that received IVK pre-, intra-, and post-operatively, respectively (p < .001 for each condition, as compared to controls). 28% of control patients required postoperative opioid analgesics, as compared to 6%, 4%, and 4% among patients that received IVK pre-, intra-, and postoperatively, respectively (p < .05 for each condition, as compared to controls).

CONCLUSIONS: IVK significantly reduces postoperative pain and the requirement for opioid analgesics after DCR, regardless of the timing of administration. This benefit appears to extend into the first postoperative day.

PMID:35491682 | DOI:10.1080/01676830.2022.2058021